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Permit C ITY OF TIGARD PLUMBING PERMIT � �r 4 DEVELOPMENT SERVICES PERMIT #: PLM2000 -00283 -°7•:)J1 13125 S W Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 08/02/2000 SITE ADDRESS: 12159 SW QUAIL CREEK LN PARCEL: 2S103C6 -10800 SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5 BLOCK: LOT: 066 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of backflow prevention device. FEES Owner: Type By Date Amount Receipt DON MORISSETTE HOMES PRMT JMT 08/02/200C $25.00 0004167 4230 GALEWOOD STREET 5PCT JMT 08/02/2000 $2.00 0004167 SUITE 100 LAKE OSWEGO, OR 97035 Total $27.00 Phone 1: 274 -5223 Contractor: PROGRASS LANDSCAPE SERVICES 29895 SW KINSMAN RD WILSONVILLE, OR 97070 REQUIRED INSPECTIONS • Phone 1: 682 -6076 RP /Backflow Preventer Reg #: LIC 00006136 PLM 11558 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Issued By: Permittee Signature: 0—e._. Call (5 ) 639 -4175 by 7:00 P.M. for an inspection needed the next business day • 06/06/99 TEE 10:57 FAX 503 598 1960 CITY OF TIGAIW .. ..- CITYOF TIGARD Plumbing Permit ApplicatiodRECEIVF^ Plan CrecX S • .• 13125 SW HALL BLVD. . Commercial and Residential . Reed By TIGARD, OR 97223 . JUL 21 1 2n .-..r Da:a Reed • • . (503) 639-4171 .. . " Da:e to P.E. • Print or Type . COMMUNITY DEVELu, Date to 03T . • • Incomplete or illegible applications will not be accepted Pem4* P --- /M 9-4D6-6v2- 6 3 • Related SWR S - . . . 1 •,&f: Cacti • - . . - - . • Name of Deveiopment/Projec: . 'igPP.J.g.g,1c164,41111VR'74q::-..-"F.P:W.; IPTY, ;;;F EtIC Et:1,07.g: . - • Job • at,k_etzt- 6kotlolo Lo 7- ( e ° . sok • 11.50 _ Address Str.t Address 1 . 1 Lavatory - . 11.50 . - • Toll S Stij ()L L Tub or Tub/Shower Comb. 11.5C . - • - - • - - - -.- .81dg # I C' /State • • -- - -- Zip_ - --- -• -.- • --- • - Shower Only . . 11.50 ... Name . - . Water Closet ., • • 11.50 • . -. . bern Merrissdic. Harries Dishwasher . - • ... . " • . . . • • /4.:.e4": • Owner Man Address Suite • Garbage Disposal - • " • 11.50 1/Q3o Sly Geliewcoct. . - Washing Mad** . 11.50 City/State Zip Phone • Ltaec bSuicya ore, 79o- to V 5-0 Floor Craln/Floor Sink 2 . . 11.50 • • Name\ . . • • 3° . • 11.50 - - - • . • 4' ' 1 1 . 50 Occupant lialling Ad . ss Suite _. Water Healer 0 conversion 0 Ike kind , 11.53 Gas piping requires a separate maChanical pnnft. • . _ • e ' • • Cfty/State Zip Phone - Laundry Room Tray .11.53 . -. Urinal 11.53 !tame -. • . . • • • i- Other Fixtures (specify) ' - 041CISC.a.p... - • - Pro GrAss Lotridsz e, Contractor Wiling Address . S uite . .. .... • 21 PI 5 9.0 kint . . . . ... . . • . Pricr to permit City/State Zip Phone bp- -- -_,. sewer- 1st 100 38.00 - Issuance. a copy WO Sin Wik Ott. Vcrlo /A0140 -7 - : - . • - .. , - • Sewer - each additional 100 32.00 - of licenses are ()regal] COn3t. Cont. Board Lk.* ... E.43. Date • -• • -.. - required if . • - (i43-( .. 1 813 / j0c, p ....- Water Service -1st 100' • . • expired in COT Plumbing tic. t Exp. Date . - Water Service - each additional 200 . •=-:,7. '• 32.00 , •-• ...,:' .:;-:•.;:-.-,.. • - ' • -:. . database • Storm & Rain Drain- 151100 Name ' • • • • . ., . .. . . . . . - Storm & Rain Drain -, each additional 100' 32.00 • _ • -- . .. Architect • '.. • . ' • Mobile Home Space - • • 3200 • or - Mailing Address • Suite - Commercial Back Flow Prevention Device or Anil- . , 32.00 ' ' • • , ••_ • . Pollution Device • Engineer atOtate Zip Phone Residential Bacidlow Prevention Device' . 19.00 /VCR '• e '' • (InIgatior tirrinc devices require a separate Describe work to be done: . restricted energy permit) - New 0 Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture • 11.50 . • Residential 0 Commercial 0 Catch Basin 11.50 - • ' Additional description of work: . • Insp. of Existing Plumbing 50.00 j • per/y • Specially Requested Inspections • - 50.00 I Are you capping, moving or replacing any fixtures? per/ir • Yes 0 No 0 Rain Drain, single family dwelling 45.00 If yes, see back of form to indicate work performed by Grease Traps 11.50 fixture. FAILURE TO ACCURATELY REPORT FIXTURE WORK COULD RESULT IN INCREASED SEWER FEES. . TOTAL 1 'i,:r. - f •-• I hereby acknowledge that : have read this application, that the information Isomeric cr rise/ &Gram Is rill:grad If Quail* Tetal Is s• 9 _1" ... _ :4 P . . ... .. .. given Is correct, that I arm the owner or authorized agent of the owner, and *SUBTOTAL • that plans submitted are in compliance with Cregon Stale Laws. = '• • 7 '.'::•"ire , ' =ettSv gent Date , 159. IS% SURCHARGE :.:::: :• • if:5 ' iV:f-a Contact Person Nerd Phoni "'PLAN REVIEW 25% OF SUBTOTAL rIll'Hglii;;I:t:'::::`.:i • Requimd Drib H tam qty. kb:1113. 9 ! NOMRIPUSZSIPP-Cii:PZII:rittigiii*.44tif.-N-1.11fatg--r_i TOTAL . f2-::] ' .!::'::41 taNnOgralZgqi-iikij.:iTil*-`;fflanl--2.13.VISNIFIACV±Rgrl .. ' t.:-:-L._..110,01...1*(39:erigrEall-ZOIMV....55:7§:-€-;,72-11;ri 'Minimum permit fee is $53 + 5% surcharge, except Residential Backftow if_ .17#13.119t-ggitiW.Paitt,...N.Wfiftialliti,A0Ifitaf-itklisairia=LF413 -- Pr_s_.reMionLli .d.__,A1.,,ece "htsia5 , 5% eurch ere e Ltit,....04-Vekairitriibitaitiktef_VOntsregiartifylitt_°41:r-I'M "All New Commercial Buildings require plans with isometric or riser diagram and plan review LicIstsnrrnapiumapp.dc: VAS • . . • CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 , ,,Z,UVU —6 e)2 Date Requested e- AM PM BLD Location /2-/ 5e-v aft(( 01,.x -ex Suite MEC Contact Person Ph 4'S') ? PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PAS RT FAIL LUMBIN Post & Beam Under Slab Top Out e N Water Servic Sanitary Sewer Rain Drains F ASS PART FAI MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date - y- d Inspector ��. ✓ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION (\/ MST 24-Flour Inspection Line: 639 -4175 Business Line: 639 -4171 95 BUP Date Requested — Y AM PM BLD Location /2 Sw 6 / Suite ME Contact Person Ph C ' - 76 PL 6p3 Contractor Ph Q k t 7 SWR BUILDING Tenant/Owner ELC ll Retaining Wall ELR I Footing Access: • F PS �� ����� w Foundation � Ftg Drain SGN Ware Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASHA T FAIL UMBI os & Beam Under Slab Top Out Water Service Sanitary Sewer Ra' ' . ! rains CI( tiGK -• 6 0 PART FAIL ANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date Inspector Ext Other Final • PASS PART FAIL DO NOT REMOVE this inspection record from the job site.